Association between Intrapartum Interventions and Breastfeeding Duration

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Factors associated with breastfeeding duration and exclusivity in mothers returning to paid employment postpartum

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Planning complex engineer-to-order products

The design and manufacture of complex Engineer-to-Order products is characterised by uncertain operation durations, finite capacity resources and multilevel product structures. Two scheduling methods are presented to minimise expected costs for multiple products across multiple finite capacity resources. The first sub-optimises the operations sequence, using mean operation durations, then refines the schedule by perturbation. The second method generates a schedule of start times directly by random search with an embedded simulation of candidate schedules for evaluation. The methods are compared for industrial examples

Valproic acid protects against haemorrhagic shock-induced signalling changes via PPARγ activation in an in vitro model.

BACKGROUND AND PURPOSE: Valproic acid (VPA), a widely used epilepsy and bipolar disorder treatment, provides acute protection against haemorrhagic shock-induced mortality in a range of in vivo models through an unknown mechanism. In the liver, this effect occurs with a concomitant protection against a decrease in GSK3β-Ser(9) phosphorylation. Here, we developed an in vitro model to investigate this protective effect of VPA and define a molecular mechanism. EXPERIMENTAL APPROACH: The human hepatocarcinoma cell line (Huh7) was exposed to conditions occurring during haemorrhagic shock (hypoxia, hypercapnia and hypothermia) to investigate the changes in GSK3β-Ser(9) phosphorylation for a 4 h period following treatment with VPA, related congeners, PPAR agonists, antagonists and siRNA. KEY RESULTS: Huh7 cells undergoing combined hypoxia, hypercapnia, and hypothermia reproduced the reduced GSK3β-Ser(9) phosphorylation shown in vivo during haemorrhagic shock, and this change was blocked by VPA. The protective effect occurred through upstream PTEN and Akt signalling, and prevented downstream β-catenin degradation while increasing histone 2/3 acetylation. This effect was reproduced by several VPA-related compounds with known PPARγ agonist activity, independent of histone deacetylase (HDAC) inhibitory activity. Specific pharmacological inhibition (by T0070907) or knockdown of PPARγ blocked the protective effect of VPA against these signalling changes and apoptosis. In addition, specific activation of PPARγ using ciglitazone reproduced the changes induced by VPA in haemorrhagic shock-like conditions. CONCLUSION AND IMPLICATIONS: Changes in GSK3β-Ser(9) phosphorylation in in vivo haemorrhagic shock models can be modelled in vitro, and this has identified a role for PPARγ activation in the protective role of VPA

Practices, predictors and consequences of expressed breast-milk feeding in healthy full-term infants

To investigate the prevalence and predictors of expressed breast-milk feeding in healthy full-term infants and its association with total duration of breast-milk feeding. Prospective cohort study. In-patient postnatal units of four public hospitals in Hong Kong. A total of 2450 mother–infant pairs were recruited in 2006–2007 and 2011–2012 and followed up prospectively for 12 months or until breast-milk feeding had stopped. Across the first 6 months postpartum, the rate of exclusive expressed breast-milk feeding ranged from 5·1 to 8·0 % in 2006–2007 and from 18·0 to 19·8 % in 2011–2012. Factors associated with higher rate of exclusive expressed breast-milk feeding included supplementation with infant formula, lack of previous breast-milk feeding experience, having a planned caesarean section delivery and returning to work postpartum. Exclusive expressed breast-milk feeding was associated with an increased risk of early breast-milk feeding cessation when compared with direct feeding at the breast. The hazard ratio (95 % CI) ranged from 1·25 (1·04, 1·51) to 1·91 (1·34, 2·73) across the first 6 months. Mothers of healthy term infants should be encouraged and supported to feed directly at the breast. Exclusive expressed breast-milk feeding should be recommended only when medically necessary and not as a substitute for feeding directly at the breast. Further research is required to explore mothers’ reasons for exclusive expressed breast-milk feeding and to identify the health outcomes associated with this practice.postprin

The Ebola outbreak, 2013-2016: old lessons for new epidemics

Ebola virus causes a severe haemorrhagic fever in humans with high case fatality and significant epidemic potential. The 2013–2016 outbreak in West Africa was unprecedented in scale, being larger than all previous outbreaks combined, with 28 646 reported cases and 11 323 reported deaths. It was also unique in its geographical distribution and multicountry spread. It is vital that the lessons learned from the world's largest Ebola outbreak are not lost. This article aims to provide a detailed description of the evolution of the outbreak. We contextualize this outbreak in relation to previous Ebola outbreaks and outline the theories regarding its origins and emergence. The outbreak is described by country, in chronological order, including epidemiological parameters and implementation of outbreak containment strategies. We then summarize the factors that led to rapid and extensive propagation, as well as highlight the key successes, failures and lessons learned from this outbreak and the response

Robust fault diagnosis for an exothermic semi-batch polymerization reactor under open-loop

An independent radial basis function neural network (RBFNN) is developed and employed here for an online diagnosis of actuator and sensor faults. In this research, a robust fault detection and isolation scheme is developed for an open-loop exothermic semi-batch polymerization reactor described by Chylla–Haase. The independent RBFNN is employed here for online diagnosis of faults when the system is subjected to system uncertainties and disturbances. Two different techniques to employ RBFNNs are investigated. Firstly, an independent neural network (NN) is used to model the reactor dynamics and generate residuals. Secondly, an additional RBFNN is developed as a classifier to isolate faults from the generated residuals. Three sensor faults and one actuator fault are simulated on the reactor. Moreover, many practical disturbances and system uncertainties, such as monomer feed rate, fouling factor, impurity factor, ambient temperature and measurement noise, are modelled. The simulation results are presented to illustrate the effectiveness and robustness of the proposed method

Prostate Cancer and Race

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72215/1/j.1525-1497.2003.30801.x.pd

Necessary and sufficient conditions of solution uniqueness in ℓ1\ell_1 minimization

This paper shows that the solutions to various convex $\ell_1$ minimization problems are \emph{unique} if and only if a common set of conditions are satisfied. This result applies broadly to the basis pursuit model, basis pursuit denoising model, Lasso model, as well as other $\ell_1$ models that either minimize $f(Ax-b)$ or impose the constraint $f(Ax-b)\leq\sigma$, where $f$ is a strictly convex function. For these models, this paper proves that, given a solution $x^*$ and defining I=\supp(x^*) and s=\sign(x^*_I), $x^*$ is the unique solution if and only if $A_I$ has full column rank and there exists $y$ such that $A_I^Ty=s$ and $|a_i^Ty|_\infty<1$ for $i\not\in I$. This condition is previously known to be sufficient for the basis pursuit model to have a unique solution supported on $I$. Indeed, it is also necessary, and applies to a variety of other $\ell_1$ models. The paper also discusses ways to recognize unique solutions and verify the uniqueness conditions numerically.Comment: 6 pages; revised version; submitte